What you need to know when shopping for health insurance

Open enrollment season is a crucial time of year for anyone shopping for health coverage. Whether you're signing up for coverage on the federal or state Marketplace or through Medicare or employee benefits, most open enrollment periods begin in the fall.

Author:
KXTV Staff

Published:
11:12 PM PDT October 28, 2016

Updated:
11:12 PM PDT October 28, 2016

Open enrollment season is a crucial time of year for anyone shopping for health coverage. Whether you’re signing up for coverage on the federal or state Marketplace or through Medicare or employee benefits, most open enrollment periods begin in the fall.

Now is your chance to make changes to your coverage for 2017. If you miss this year’s open enrollment period, you will have to wait another year to alter your plan unless you have a major life event (marriage, a child, etc.).

Here are some tips to keep in mind as you review your health coverage this year:

1. Know your deadlines

Medicare: Open enrollment for 2017 coverage is between Oct. 15 and Dec. 7. Find more information here.

Obamacare: Open enrollment begins Nov. 1 and ends Jan. 31. However, you must sign up for benefits by Dec. 15 if you want your coverage to begin Jan. 1, 2017. Sign up for deadline reminders here.

Employee benefits: This will depend on your employer. Many employers schedule open enrollment in the fall. By now, you should have received a notification from your human resources department with information on how to enroll.

2. Don't get complacent

You might love the benefits you have at the moment, but that doesn’t mean you should blindly sign up for the same plan next year. Insurers are constantly tweaking existing coverage areas and creating new plans. Check to see if your existing plan has changed and see if there are new plans.

3. Lower your out-of-pocket expenses with a Flexible Spending Account

Americans are paying the highest out-of-pocket health care expenses in history, due to a shift toward high-deductible plans. You can lower your out-of-pocket expenses by setting aside pretax dollars in a Flexible Spending Account. FSAs are only available to workers whose employer provides them.

FSAs can be used only for certain medical expenses, such as co-pays, prescriptions, and some over-the-counter medications. The maximum contribution is $2,550 for 2016.

4. Take advantage of a Health Savings Account if you have a high-deductible health plan

Like an FSA, you contribute pretax dollars to a Health Savings Account (HSA) to cover your medical expenses. However, HSAs are not tied to any one employer, which means they are portable. Your money will come with you from one job to the next, and you won’t be limited on where you can use it. You can also make changes anytime throughout the year. In order to qualify for an HSA in 2017, your health plan deductible must be higher than $1,300 for an individual and $2,600 for a family.

5. Learn from last year's mistakes

This is your chance to find a plan that fits your budget and your needs. Insurance companies change coverage rates and options frequently, so take the opportunity to do your research and flesh out all of your options this enrollment season. If you went for a low-premium, high-deductible plan this year, you might have realized you don’t really like paying higher out-of-pocket expenses all that much. Similarly, if you’ve paid for a high-premium, low-deductible plan but don’t use your health insurance that much, you may join the ranks of the growing number of Americans who have switched over to high-deductible health care plans over the past few years.

6. Check to see if you qualify for a tax credit

Like 84% of Obamacare consumers, you might be eligible for a tax credit that would lower your monthly premium. The average subsidy in 2016 was $290/month. If your estimated household income is up to four times the federal poverty level, then you’d qualify for the credit. You can check here to see if you qualify for a subsidy.

7. If you decide to forego insurance, know what to expect

Under the Affordable Care Act, every American has to have qualifying health insurance coverage, or pay a tax penalty. For 2016, the penalty is $695 for each uninsured adult in the household. However, there are a few exceptions. You might qualify for an exemption from the penalties under certain circumstances. For example, you won't face a penalty if you suddenly lose a job or you are in between jobs for 1 or 2 months and have a gap in coverage. You should check to see if any exemptions apply to you before skipping out on signing up this enrollment season.

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